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Other Mental Illnesses

Facts for Policymakers: Treatable Causes of Disability

Treatment Issues for People with Depressive, Bipolar and Anxiety Disorders - Access to Medications is Critically Important

Unlike many medications that treat other illnesses, medications that treat mood disorders cannot be used interchangeably.

Each medication has a very different mechanism of action. Because the brain is such a complex organ and mood disorders are so complex, medications affect each person’s brain in a very different way.

The side effects of these medications can be extremely serious, and vary with each patient.

Changing Medications is Not Easy

Changing medications for people with these disorders is very difficult. It can take up to 6-12 weeks to determine if a medication works, and if not, additional weeks with no medication are required before a new one is tried.

Each failed trial results in suffering and possible worsening of a patient’s condition.

Changing medications for people with these disorders is very difficult. It can take up to 6-12 weeks to determine if a medication works, and if not, additional weeks with no medication are required before a new one is tried.

Denying Needed Medications Does Not Save Money for the State

Little or no real cost savings, even in the short run, will result from Medicaid cuts that limit medication choice and services for people with mental illness, or reduce eligibility.

Authorization Poses a Threat to Patients

Because patients are less likely to adhere to treatment on medications that are not best for them, they are more likely to suffer a serious episode. This is a primary reason that the Kaiser Family Foundation report on prior authorization programs recommended that medications for mental illness be exempted for restrictive formularies.

Depressive, bipolar and anxiety disorders are not all alike, and cannot be approached with a "one-size fits all" mentality.

Policy decisions that cut medicines often push costs into more expensive venues, such as emergency departments and jails. Early intervention is less costly than late or no treatment.

Prior Authorization Poses a Threat to Patients --Because patients are less likely to adhere to treatment on medications that are not best for them, they are more likely to suffer a serious episode.

Conclusion

Given the budget crisis in many states, some policymakers may be tempted to limit access to medications for people with depressive, bipolar and anxiety disorders to save money. However, this is not the way to create an effective, efficient mental health system for those on Medicaid.

States should use tested, proven treatment models for depressive, bipolar and anxiety disorders that allow physicians to make final treatment decisions for individual patients. Increasingly, individuals with these disorders can focus on recovery and their well being and quality of life can be significantly improved with open access to medications.

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